Aortic Stenosis Overview

Learn about Bicuspid Aortic Valves and Mitral Valve Prolapse

What is aortic valve stenosis (AS)?

Stenosis animation

Aortic stenosis is one of the most common and most serious valve disease problems. Aortic stenosis is a narrowing of the aortic valve opening. Aortic stenosis restricts the blood flow from the left ventricle to the aorta and may also affect the pressure in the left atrium.

Watch an animation of aortic valve stenosis.

Although some people have AS as a result of a congenital heart defect called a bicuspid aortic valve, this condition more commonly develops during aging as calcium or scarring damages the valve and restricts the amount of blood flowing through the valve.

Does aortic stenosis always produce symptoms?

No, not always. It's important to note that many people with AS do not experience noticeable symptoms until the amount of restricted blood flow becomes significantly reduced.

Symptoms of aortic stenosis may include:

  • Breathlessness
  • Chest pain (angina), pressure or tightness
  • Fainting, also called syncope
  • Palpitations or a feeling of heavy, pounding, or noticeable heartbeats
  • Decline in activity level or reduced ability to do normal activities requiring mild exertion
  • Heart murmur

It may be important to note that the person suffering from AS may not complain of symptoms. However, if family members notice a decline in routine physical activities or significant fatigue, it is worth a visit to your healthcare provider to check for the possibility of reduced heart function.

Infants and children, who have aortic stenosis due to a congenital defect, may exhibit symptoms such as:

  • Fatigue upon exertion
  • Failure to gain weight
  • Poor or inadequate feeding
  • Breathing problems

How does aortic stenosis progress or cause increasing problems?

In addition to the symptoms of aortic stenosis, which may cause a patient to feel faint, weak, or lethargic, the wall of the left ventricle may also show muscular thickening because the ventricle must work harder to pump blood through the narrow valve opening into the aorta.

The thickened wall takes up more space inside the lower heart chamber which allows less room for an adequate amount of blood to be supplied to the body, which in turn may cause heart failure. Early treatment can help to reverse or slow down the progress of this disease.

Who is at risk for aortic stenosis?

Aging people

Aortic stenosis mainly affects older people - the result of scarring and calcium buildup in the valve cusp (flap or fold). Age-related aortic stenosis usually begins after age 60, but often does not show symptoms until ages 70 or 80.

AS in the young

bicuspid valves may restrict blood flow

The most common cause of aortic stenosis in young people is a birth defect where only two cusps grow instead of the normal three, which is called a “bicuspid valve.”

Another cause may be that the valve opening does not grow along with the heart, which makes the heart work harder to pump blood to the restricted opening. Over the years the defective valve often becomes stiff and narrow because of calcium build-up.

What treatments are advisable for people with aortic stenosis?

If there are no symptoms or if symptoms are mild, a healthcare provider may advise that the best course of action is to simply monitor and follow up on any changes.

However, anyone with aortic stenosis should be checked with an echocardiogram (heart ultrasound) to confirm the safest and best options for treatment. Conversely, even if no symptoms are present, it may be advisable to proceed with treatment or repairs based on the test results.

Possible treatments may include valve repair or valve replacement. If consensus is reached and surgery is recommended, it is important to proceed without postponing this important treatment.

Understanding your heart valve problem: Which solution may be right for you?

Walk through a step-by-step interactive guide explaining your valve issue and treatment options with helpful videos, text summaries and links along the way.

Additional resources:

Susan's Heart Valve Story: Initial Causes of Aortic Stenosis

Heart Valve Disease Resources

Find out more about your heart valves and how to manage heart valve disease.

Valve Stenosis: When a Heart Valve is Too Narrow
Understanding Heart Murmurs, Aortic and Mitral Valve Problems

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